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Journal of Behavioral Addictions
Authors:
Lucero Munguía
,
Susana Jiménez-Murcia
,
Roser Granero
,
Isabel Baenas
,
Zaida Agüera
,
Isabel Sánchez
,
Ester Codina
,
Amparo del Pino-Gutiérrez
,
Giulia Testa
,
Janet Treasure
, and
Fernando Fernández-Aranda

Abstract

Background and aims

Difficulties in Emotion Regulation (ER) are related to the etiology and maintenance of several psychological disorders, including Eating Disorders (ED) and Gambling Disorder (GD). This study explored the existence of latent empirical groups between both disorders, based on ER difficulties and considering a set of indicators of personality traits, the severity of the disorder, and psychopathological distress.

Methods

The sample included 1,288 female and male participants, diagnosed with ED (n = 906) and GD (n = 382). Two-step clustering was used for the empirical classification, while analysis of variance and chi-square tests were used for the comparison between the latent groups.

Results

Three empirical groups were identified, from the most disturbed ER profile (Subgroup 1) to the most functional (Subgroup 3). The ER state showed a linear relationship with the severity of each disorder and the psychopathological state. Different personality traits were found to be related to the level of emotion dysregulation.

Discussion and conclusion

In this study, three distinct empirical groups based on ER were identified across ED and GD, suggesting that ER is a transdiagnostic construct. These findings may lead to the development of common treatment strategies and more tailored approaches.

Open access
Journal of Behavioral Addictions
Authors:
Roser Granero
,
Fernando Fernández-Aranda
,
Susana Valero-Solís
,
Amparo del Pino-Gutiérrez
,
Gemma Mestre-Bach
,
Isabel Baenas
,
S. Fabrizio Contaldo
,
Mónica Gómez-Peña
,
Neus Aymamí
,
Laura Moragas
,
Cristina Vintró
,
Teresa Mena-Moreno
,
Eduardo Valenciano-Mendoza
,
Bernat Mora-Maltas
,
José M. Menchón
, and
Susana Jiménez-Murcia

Abstract

Background and aims

Due to the contribution of age to the etiology of gambling disorder (GD), there is a need to assess the moderator effect of the aging process with other features that are highly related with the clinical profile. The objective of this study is to examine the role of the chronological age into the relationships between cognitive biases, impulsivity levels and gambling preference with the GD profile during adulthood.

Methods

Sample included n = 209 patients aged 18–77 years-old recruited from a Pathological Gambling Outpatients Unit. Orthogonal contrasts explored polynomial patterns in data, and path analysis implemented through structural equation modeling assessed the underlying mechanisms between the study variables.

Results

Compared to middle-age patients, younger and older age groups reported more impairing irrational beliefs (P = 0.005 for interpretative control and P = 0.043 for interpretative bias). A linear trend showed that as people get older sensation seeking (P = 0.006) and inability to stop gambling (P = 0.018) increase. Path analysis showed a direct effect between the cognitive bias and measures of gambling severity (standardized effects [SE] between 0.12 and 0.17) and a direct effect between impulsivity levels and cumulated debts due to gambling (SE = 0.22).

Conclusion

Screening tools and intervention plans should consider the aging process. Specific programs should be developed for younger and older age groups, since these are highly vulnerable to the consequences of gambling activities and impairment levels of impulsivity and cognitive biases.

Open access
Journal of Behavioral Addictions
Authors:
Roser Granero
,
Susana Valero-Solis
,
Fernando Fernández-Aranda
,
Mónica Gómez-Peña
,
Laura Moragas
,
Teresa Mena-Moreno
,
Amparo del Pino-Gutierrez
,
Ester Codina
,
Virginia Martín-Romera
,
Gemma Casalé
,
Zaida Agüera
,
Isabel Baenas-Soto
,
Eduardo Valenciano-Mendoza
,
Bernat Mora-Maltas
,
Isabel Sánchez
,
María Lozano-Madrid
,
José M. Menchón
, and
Susana Jiménez Murcia

Abstract

Background and aims

The significant increase in the prevalence of gambling disorder (GD) among young adults in recent years has attracted interest in determining therapeutic efficiency in this sector of the population. The aim of this work was to estimate the response trajectories of gambling severity during the six-month follow-up after a cognitive behavioral therapy (CBT) program in young adult patients and to identify the main variables associated with each trajectory.

Methods

The sample included n = 192 patients, aged 19–35 years old, seeking treatment for GD. Response trajectories were identified through latent class growth analysis.

Results

Three trajectories emerged: T1 (n = 118, 61.5%), composed of patients with severe GD at pre-treatment and good evolution to recovery; T2 (n = 62, 32.3%), with patients with moderate-high GD affectation at baseline and good evolution to recovery; and T3 (n = 12, 6.3%), with participants with severe baseline GD severity and poor evolution after CBT (Abbott, 2019). The highest risk of poor therapeutic outcomes was related to lower social index positions, high emotional distress, high scores in harm avoidance and low scores in self-directedness.

Discussion and conclusions

Differences in the response trajectories at short-term follow-up after CBT reveal heterogeneity in the samples including young and young-adult GD patients. Patients' phenotype at baseline should be considered when developing efficient, person-centered intervention programs, which should comprise strategies aimed at increasing emotional regulation capacities, self-esteem and self-efficacy, with the aim of avoiding relapses in the medium-long term after therapy.

Open access
Journal of Behavioral Addictions
Authors:
Juan C. Uríszar
,
Anahí Gaspar-Pérez
,
Roser Granero
,
Lucero Munguía
,
Milagros L. Lara-Huallipe
,
Bernat Mora-Maltas
,
Isabel Baenas
,
Mikel Etxandi
,
Mónica Gómez-Peña
,
Laura Moragas
,
Claudia Sisquellas
,
Fernando Fernández-Aranda
, and
Susana Jiménez-Murcia

Abstract

Background and aims

Self-exclusion in gambling disorder (GD) is considered a measure to decrease the negative consequences of gambling behavior. Under a formal self-exclusion program, gamblers request to be banned from accessing to the gambling venues or online gambling.

The aims of the present study are

1) to determine sociodemographic characteristics of a clinical sample of seeking-treatment patients with GD who are self-excluded before arriving at the care unit; 2) to identify personality traits and general psychopathology of this clinical population; 3) to analyze the response to treatment, in terms of relapses and dropouts.

Methods

1,416 adults seeking treatment for GD, who are self-excluded completed screening tools to identify GD symptomatology, general psychopathology, and personality traits. The treatment outcome was measured by dropout and relapses.

Results

Self-exclusion was significantly related to female sex and a high sociodemographic status. Also, it was associated with a preference for strategic and mixed gambling, longest duration and severity of the disorder, high rates of general psychopathology, more presence of illegal acts and high sensation seeking rates. In relation to treatment, self-exclusion was associated with low relapse rates.

Conclusions

The patients who self-exclude before seeking treatment have a specific clinical profile, including high sociodemographic status, highest severity of GD, more years of evolution of the disorder and high emotional distress rates; however, these patients' presents better response to treatment. Clinically, it could be expected that this strategy could be used as a facilitating variable in the therapeutic process.

Open access
Journal of Behavioral Addictions
Authors:
Mikel Etxandi
,
Isabel Baenas
,
Bernat Mora-Maltas
,
Roser Granero
,
Fernando Fernández-Aranda
,
Sulay Tovar
,
Neus Solé-Morata
,
Ignacio Lucas
,
Sabela Casado
,
Mónica Gómez-Peña
,
Laura Moragas
,
Amparo del Pino-Gutiérrez
,
Javier Tapia
,
Eduardo Valenciano-Mendoza
,
Marc N. Potenza
,
Ashley N. Gearhardt
,
Carlos Diéguez
, and
Susana Jiménez-Murcia

Abstract

Background

Data implicate overlaps in neurobiological pathways involved in appetite regulation and addictive disorders. Despite different neuroendocrine measures having been associated with both gambling disorder (GD) and food addiction (FA), how appetite-regulating hormones may relate to the co-occurrence of both entities remain incompletely understood.

Aims

To compare plasma concentrations of ghrelin, leptin, adiponectin, and liver-expressed antimicrobial peptide 2 (LEAP-2) between patients with GD, with and without FA, and to explore the association between circulating hormonal concentrations and neuropsychological and clinical features in individuals with GD and FA.

Methods

The sample included 297 patients diagnosed with GD (93.6% males). None of the patients with GD had lifetime diagnosis of an eating disorder. FA was evaluated with the Yale Food Addiction Scale 2.0. All patients were assessed through a semi-structured clinical interview and a psychometric battery including neuropsychological tasks. Blood samples to measure hormonal variables and anthropometric variables were also collected.

Results

From the total sample, FA was observed in 23 participants (FA+) (7.7% of the sample, 87% males). When compared participants with and without FA, those with FA+ presented both higher body mass index (BMI) (p < 0.001) and leptin concentrations, after adjusting for BMI (p = 0.013). In patients with FA, leptin concentrations positively correlated with impulsivity, poorer cognitive flexibility, and poorer inhibitory control. Other endocrine measures did not differ between groups.

Discussion and conclusions

The present study implicates leptin in co-occurring GD and FA. Among these patients, leptin concentration has been associated with clinical and neuropsychological features, such as impulsivity and cognitive performance in certain domains.

Open access
Journal of Behavioral Addictions
Authors:
Susana Jiménez-Murcia
,
Mónica Giménez
,
Roser Granero
,
Hibai López-González
,
Mónica Gómez-Peña
,
Laura Moragas
,
Isabel Baenas
,
Amparo Del Pino-Gutiérrez
,
Ester Codina
,
Teresa Mena-Moreno
,
Eduardo Valenciano-Mendoza
,
Bernat Mora-Maltas
,
Susana Valero-Solís
,
Sandra Rivas-Pérez
,
Elías Guillén-Guzmán
,
José M. Menchón
, and
Fernando Fernández-Aranda

Abstract

Background and aims

Sports betting has been barely explored independently from other gambling behaviors. Little evidence is available regarding the factors affecting its severity in a clinical sample. The current study explores new determinants for sports betting severity in Spain by the inclusion of psychopathological distress and personality factors.

Methods

A sample of 352 Spanish sports bettors undergoing treatment for gambling disorder was recruited. Multiple regression models were used to evaluate the effects of sociodemographic variables, the age of onset of gambling behavior, the global psychopathological distress (SCL-90R GSI) and the personality profile (TCI-R) on sports betting severity and their influence over frequency (bets per episode) and debts due to gambling.

Results

We found that older age, higher psychopathological distress, lower self-directedness level, and higher novelty seeking level were predictors of gambling severity in Spanish sports bettors. The highest betting frequency was found in men, with the lowest education levels but the highest social status, the highest psychopathological distress, reward dependence score, and self-transcendence trait and the lowest persistence score. Debts were also associated to higher score in cooperativeness as well as older age.

Discussion and conclusions

Our findings call for further exploration of factors affecting sports betting severity regarded as a separate gambling entity subtype, as some of the traditional factors typically found in gamblers do not apply to sports bettors or apply inversely in our country. Consequently, sports bettors might deserve specific clinical approaches to tackle the singularities of their gambling behavior.

Open access